Digital Commons Network^™

Pristine Or Perilous? Evaluating The Risks Of Cyanotoxin Production, Exposure, And Accumulation In Gye Lakes, Katherine Low

Doctoral Dissertations

Toxins produced by cyanobacteria (hereafter, cyanotoxins) are among the most lethal known biotoxins. Cyanotoxin exposure is assumed to occur mainly through direct contact with surface-bloom-forming cyanobacteria that are most commonly observed in warm, nutrient-rich lakes. However, recent observations of cyanotoxin accumulation in the Greater Yellowstone Ecosystem (GYE), an area where cyanobacteria blooms are rarely observed, have raised concerns over wildlife health in this highly protected region. In response, we sampled twelve clear-water lakes in the GYE to identify potential sources of cyanotoxins (particularly the neurotoxin beta-methylamino-L-alanine, BMAA), exposure routes, and health risks.Despite nutrient limitations and cool water temperatures, the sampled …

Sepsis Screening And Bundle Adherence: Staff Education As An Intervention To Increase Knowledge In A Medical Surgical Clinical Microsystem, Nicole Elise Maheu

Master's Theses and Capstones

Background: Sepsis-related deaths outnumber those caused by opioids, breast cancer, and prostate cancer combined (Nguyen, 2020). Sepsis places a significant health burden and cost burden on both an individual and a systemic level, emphasizing the need for proper care of the sepsis patient in all inpatient settings.

Local Problem: Within a medical-surgical microsystem, it was found that care of the sepsis patient was inadequate. A pre-intervention survey was conducted which demonstrated a lack in knowledge of the inpatient sepsis workflow, including use of the sepsis best practice advisory (BPA) within EPIC® and the sepsis bundle of care. Additionally, according to …

4-H Horse Knowledge Bowl Entry Packet, Extension

UNH Cooperative Extension

No abstract provided.

Assessing And Understanding Soil Characteristics​, Amy Papineau

UNH Cooperative Extension

No abstract provided.

Responding To Aggression In Dementia-Related Diseases, Michele Kroll

UNH Cooperative Extension

No abstract provided.

2024 Directory Of Landscape Professionals Trained In Ecological Landscaping For Water Quality Protection, Julia Peterson

UNH Cooperative Extension

No abstract provided.

2023 Health & Well-Being Team Highlights, Amy Hollar, Kendra Lewis, Michael C. Young

UNH Cooperative Extension

No abstract provided.

Mental Health Resource Guide Belknap County, Suzanne Meattey

UNH Cooperative Extension

No abstract provided.

2024 Belknap County 4-H Presents, Karen Deighan

UNH Cooperative Extension

No abstract provided.

Olli Spring 2024 Catalog, Toniann Leavitt

Osher Lifelong Learning Institute

No abstract provided.

Neurodiversity In Workplace, Jacqueline L. Zindell

M.S. in Leadership

This research paper explores the intricate relationships between neurodiverse and neurotypical individuals within the workplace. Through an exploration of the literature, the research focuses on the specific challenges faced by neurodiverse individuals, including those with conditions such as autism, attention-deficit/hyperactivity disorder (ADHD), and dyslexia. The topic of neurodiversity will provide support to leaders in navigating interactions with neurodiverse individuals and fostering inclusivity in the workplace. This research serves as a foundational step towards creating a toolbox for the workplace. A survey was conducted using Survey Monkey to gauge respondents' familiarity with the concept of Neurodiversity and to identify effective strategies …

Town Of Lempster, New Hampshire, Incorporated 1767, Annual Reports For The Year Ending December 31, 2023., Lempster Town Representatives

Lempster, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Empowering Nurse Leaders To Achieve Harmony: Fostering Work-Life Balance, Gilberto Gamba

DNP Scholarly Projects

BACKGROUND: Balancing professional and personal life demands has become a focal point in today’s healthcare organizational culture. Despite the technological advances in providing better and faster healthcare, team members often struggle to achieve work-life harmony while meeting the demands of a growing population of healthcare clients. The evidence highlights nurse leaders as one group for which the identification and implementation of work-life balance interventions is crucial.

METHODS: An original tool based on available evidence was developed and used with a group of nurse leaders participating in an educational activity to engage them in behaviors supporting work-life harmony. A post-educational survey …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care For Medically Underserved Community Using A Collaborative Care Model, Christina M. Stephens

DNP Scholarly Projects

Primary care, an extension of family medicine remains a key access point for patients entering the healthcare system. Accessing specialty psychiatric services can be limited in rural communities due to provider shortages and geographical constraints. Primary care providers can facilitate improved access to behavioral health services by introducing a collaborative approach to the traditional medical model. This quality improvement initiative adopted the collaborative care model originally produced by the University of Washington to treat common mental health conditions in the medical setting (2023). A team consisting of a primary care provider, behavioral health case manager and psychiatric consultant served nine …

Implementation Of Advanced Airway Management Course: A Pilot Quality Improvement Project For Improved Emergency Outcomes For Operating Room And Pacu Nurses, Elizabeth Patry

DNP Scholarly Projects

Background: Airway management has always been central to critical care; it is a complex skill to learn and necessary for patient survival. To properly care for a patient’s airway, the provider must fully understand airway anatomy including upper and lower anatomy and how they work together to allow for oxygen transportation (Day, 2022). Unfortunately, many nursing school curriculums and department orientations are not able to provide the level of education and training necessary. Due to an extreme nursing shortage, many hospitals are not able to provide in depth orientations upon hire and annual review, this lack of professional support affects …

Reducing Wait Times In The Medical Clinic Of The Homeless Intake Center: A Quality Improvement Project, Otuodichinma Christy Nwankpa, Otuodichinma Christy Nwankpa

DNP Scholarly Projects

Background: Homelessness in the U.S. is a critical issue, with New York City experiencing significant challenges due to an increasing number of families requiring shelter. The Department of Homeless Services (DHS-NYC) faces operational inefficiencies, particularly in the medical clinic at the intake center, leading to prolonged wait times.

Local Problem: Families with children experience long wait times in the DHS-NYC medical clinic, which impacts their overall health and well-being. Reducing these wait times is essential for improving service delivery and families satisfaction.

Purpose:

This quality improvement project aims to reduce wait times for families with children at the medical clinic …

Reducing Burnout And Enhancing Resilience Of Psychiatric Nurses Through Self-Care Practices., Bosede Akilo

DNP Scholarly Projects

ABSTRACT

Background: Burnout is a pervasive issue among healthcare workers, particularly mental health nurses (MHNs), leading to emotional exhaustion, depersonalization, and decreased job satisfaction. Burnout is responsible for a high turnover in MHNs, low motivation, and medical errors which is the third leading cause of death, due to the stressors within the work environment. Mental health settings are marked with huge emotional challenges that lead to the characteristic burnout presentations exhibited by the staff. The local problem being addressed is that MHNs face significant stressors, including high workloads, aggressive patient interactions, and lack of support, which contribute to burnout. The …

Enhanced Neuroprotection And Neuropromotion In Extremely Premature Infants Through Mindful Hands-On Care And Increased Family Involvement, Kristen Sergott

DNP Scholarly Projects

Background: Medical breakthroughs including antenatal corticosteroids and exogenous surfactants have improved survival in extremely premature and extremely low birth weight (EP-ELBW) infants. Currently, babies as young as 22 weeks’ gestation are being actively resuscitated and provided with intensive care in neonatal intensive care units (NICUs) around the world. As a consequence of premature delivery, fragile and immature newborns are at risk for significant morbidities affecting their multiple organ systems. Additionally, such infants encounter neurodevelopmental trauma induced by recurrent stressful experiences ubiquitous to the NICU. Postnatal stress contributes to alterations in the hypothalamic-pituitary-adrenal (HPA) axis and is associated with alterations in …

Natural Laboratories Of The Deep Sea: Linking Community Composition And Environmental Variables On Low-Temperature Venting Outcrops Of Ridge Flank Hydrothermal Systems To Explore Potential Impacts Of Climate Change, Inform Habitat Suitability Models, And To Understand The Impacts Of High Bathymetric Resolution On Seafloor Characterization, Anne Marie Hartwell

Doctoral Dissertations

The deep sea covers over two-thirds of the globe and represents 95% of the ocean. Most life on Earth is suspected to live on or near the seabed. Yet, these ecosystems are the least known on Earth and are important to explore as they are home to a diverse array of species that are currently under threat because of multiple anthropogenic pressures, including warming oceans. Exploration of these systems is critical to further the understanding of species interactions, biodiversity and their overall relationship to environmental and terrain variables. Many of these variables are used in species distribution models and technological …

Tbp1: An Essential Regulator Of Transcription In Toxoplasma Gondii, Robert Kelly

Master's Theses and Capstones

Transcription is well-conserved across eukaryotes, lending itself to countless studies in model organisms. Still, some early-diverging eukaryotes, such as Apicomplexans, continue to deviate from canonical gene expression. One such Apicomplexan is the single-celled parasite, Toxoplasma gondii. Toxoplasma maintains many elements of conventional eukaryotic transcription but demonstrates a relatively short 8-hour replication time. This suggests that transcription is tightly regulated in these parasites, consistent with their ability to differentiate between life stages per the demand of the host environment. Transcription initiation has, however, remained elusive in Toxoplasma. The formation of a preinitiation complex (PIC) has not been characterized as the parasites …

Improving Patient Safety And Continuity Of Care By Educating Nurses About Standardized Handoffs In The Post-Anesthesia Care Unit: A Quality Improvement Project, Remi Dos Santos

Master's Theses and Capstones

Background: Effective communication during patient handoffs is crucial for ensuring patient safety and continuity of care. The I-PASS handoff tool has been identified as an effective method to standardize communication and reduce errors during these critical transitions.

Local Problem: In the Post-Anesthesia Care Unit (PACU) of a hospital in New England, the lack of standardized procedures for nurse handoffs posed a risk to patient safety and care quality.

Methods: A quality improvement project was conducted using the Plan-Do-Study-Act (PDSA) cycle to implement and evaluate an educational intervention aimed at improving PACU nurses' proficiency with the I-PASS handoff tool. Pre- and …

On The Role Of Alfvénic Fluctuations As Mediators Of Coherence Within Interplanetary Coronal Mass Ejections: Investigation Of Multi-Spacecraft Measurements At 1 Au, Camilla Scolini, Noé Lugaz, Réka M. Winslow, Charles J. Farrugia, Norbert Magyar, Fabio Bacchini

Faculty Publications

Interplanetary coronal mass ejections (ICMEs) are defined as “coherent” if they are capable of responding to external perturbations in a collective manner. This implies that information must be able to propagate across ICME structures, and if this is not the case, single-point in situ measurements cannot be considered as indicative of global ICME properties. Here, we investigate the role of Alfvénic fluctuations (AFs) as mediators of ICME coherence. We consider multipoint magnetic field and plasma measurements of 10 ICMEs observed by the ACE and Wind spacecraft at 1 au at longitudinal separations of 0.5°–0.7°. For each event, we analyze the …

Examining The Utility Of The Early Childhood Development Index (Ecdi) Among 3- To 4-Year-Olds In The Nigeria Context, Ngozi V. Enelamah, Smitha Rao, Margaret Lombe, Mansoo Yu, Chrisann Newransky, Melissa L. Villodas, Andrew Foell, Von Nebbitt

Faculty Publications

An estimated six million of over 31 million children under five years old are at risk of not reaching their full developmental potential in Nigeria. There is a need for culturally appropriate and context-specific measures to track child development and facilitate intervention planning. This study assessed the utility of the Early Childhood Development Index (ECDI), see Table 1, used in the 2016/2017 round of the Multiple Indicator Cluster Survey (MICS) to track development among 3- to 4-year-old children (n=11,073; 3-year-old, 51%; female, 49%).

The Intersection Of Gender, Caregiving, And Research Productivity During The Covid-19 Pandemic: A Multi-Method Study, Elizabeth A. Moschella-Smith, Sharyn J. Potter

Faculty Publications

The COVID-19 pandemic differentially impacted the productivity of women researchers with children compared to men, with and without children. The purpose of the present study was to examine the relationship between gender, caregiving responsibilities, and research productivity before and during the pandemic. We quantitatively and qualitatively analyzed survey (n=227) and follow-up interview data (n=44) collected from faculty and staff at a Carnegie Classification Research 1 public university. Findings suggest that women researchers with children faced increased caregiving demands and diminished research productivity during the pandemic, compared to men with children and researchers without children. As illustrated by the qualitative data, …

X-Ray Polarization Of The Eastern Lobe Of Ss 433, Philip Kaaret, Riccardo Ferrazzoli, Stefano Silvestri, Michela Negro, Alberto Manfreda, Kinwah Wu, Enrico Costa, Paolo Soffitta, Samar Safi-Harb, Juri Poutanen, Alexandra Veledina, Alessandro Di Marco, Patrick Slane, Stefano Bianchi, Adam Ingram, Roger W. Romani, Nicolò Cibrario, Brydyn Mac Intyre, Romana Mikus̆Incová, Ajay Ratheesh, James F. Steiner, Jiri Svoboda, Stefano Tugliani, Iván Agudo, Lucio A. Antonelli

Faculty Publications

How astrophysical systems translate the kinetic energy of bulk motion into the acceleration of particles to very high energies is a pressing question. SS 433 is a microquasar that emits TeV γ-rays indicating the presence of high-energy particles. A region of hard X-ray emission in the eastern lobe of SS 433 was recently identified as an acceleration site. We observed this region with the Imaging X-ray Polarimetry Explorer and measured a polarization degree in the range 38%–77%. The high polarization degree indicates the magnetic field has a well-ordered component if the X-rays are due to synchrotron emission. The polarization angle …

Strafford County 2023 Annual Report Of The Commissioners, Treasurer, Other County Officers, And The Strafford County Delegation For The Year Ending December 31, 2023, Strafford County Representatives

Strafford County, NH Annual Reports

This is an annual report containing vital statistics for a county in the state of New Hampshire.

Implementing Change: Training For Adult Emergency Assessment, Recognition, And Stabilization For Novice And Non-Critical Care Nurses, Shannon C. Clancy-Burgess

Master's Theses and Capstones

Abstract

Background At a macrosystem in New England hospital nurses are requesting more training for better preparedness in situations of clinical deterioration in the patient. Current education offerings were focused on cardiac and respiratory arrest situations. Review of the literature reveals the need for training in recognition and response to clinical deterioration. Simulation training can be a useful training tool.

Methods Several assessments were conducted to determine the need for a new course that focuses on recognition and response for stabilization. These assessments included an AHRQ Gap Analysis, a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, Stakeholder feedback using Qualtricsä, …

Enhancing Chest Pain And Oxygen Supplementation Protocol Adherence Through Nurse Education In The Emergency Department For Patients With Acute Coronary Syndrome And Unspecified Chest Pain: A Quality Improvement Project, Leah Gamble

Master's Theses and Capstones

Abstract Background: Acute Coronary Syndrome (ACS) and unspecified chest pain are common presentations in the Emergency Department (ED). Proper management, including appropriate oxygen supplementation, is crucial for optimal patient outcomes. However, discrepancies between current practice and evidence-based guidelines have been identified, highlighting a need for targeted educational interventions.

Local Problem: In the ED, knowledge gaps among nurses regarding the correct administration of supplemental oxygen for patients with ACS and unspecified chest pain have been observed. This inconsistency with the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines may lead to poor patient outcomes.

Methods: The Plan-Do-Study-Act (PDSA) …

Increasing Pediatric Vaccination Rates Through Parental Education At A Federally Qualified Community Health Center: An Evidence-Based Quality Improvement Project, Dayna Dicola

Master's Theses and Capstones

Background: Childhood immunization rates for children aged 2 years and under at a community health center were assessed and determined to be below optimal levels. Immunizations protect against preventable diseases (Hill, 2023). The project assessed the microsystem to understand low immunization rates and to guide strategies for improvement.

Methods: The Plan-Do-Study-Act (PDSA) model was used. In the planning phase, key stakeholders were consulted to assess current rates and barriers contributing to immunization rates. The chosen intervention was placed simplified immunization schedules in pediatric exam rooms to educate parents and promote adherence.

Intervention: A visual guide detailing the recommended vaccination schedule …